The proposal seeks to enable the following changes in the state’s Medicaid system:
• Pay for improved patient outcomes instead of for individual services provided
• Integrate physical and mental health services
• Increase flexibility to invest in external factors to improve health
• Extend help to children of people with substance abuse problems to increase the likelihood of reuniting families
• Offer incentives to providers to improve long-term health outcomes
• Share the cost of care between the state and health plans and providers
The waiver application follows last September’s passage of legislation that shifted Medicaid to a managed care system, hoping to prevent North Carolina from overspending while caring for a growing number of people. North Carolin has not opted to expand Medicaid.
CMS is expected to spend at least 18 months reviewing the waiver request. If approved, state officials estimate another 18 months to implement the changes.
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